Objective: This article reviews the available
data on social functioning in depression and provides clinical
guidelines and opinion on this important and expanding field.

Data sources: A MEDLINE search was conducted to
identify all English-language articles (1988-1999) using the
search terms depression and social functioning, depression and
social adjustment, depression and psychosocial functioning, and social functioning and antidepressant. Further articles
were obtained from the bibliographies of relevant articles.

Data synthesis: Depressive disorders are
frequently associated with significant and pervasive impairments
in social functioning, often substantially worse than those
experienced by patients with other chronic medical conditions.
The enormous personal, social, and economic impact of depression,
due in no small part to the associated impairments in social
functioning, is often underappreciated. Both pharmacologic and
psychotherapeutic approaches can improve social impairments,
although there is a lack of extended, randomized controlled
trials in this area using consistent assessment criteria.

Conclusion: Despite this lack, it is becoming
clear that not all treatments are equally effective in relieving
the impaired social functioning associated with depressive
disorders. Furthermore, efficacy in relieving the core symptoms
of depression does not necessarily guarantee efficacy in
relieving impaired social functioning.